RESUMEN
Background: objective of the study was to evaluate adherence to therapy and factors associated with non-adherence in type 2 diabetes mellitus patients on multiple drug therapy.Methods: A prospective, cross-sectional, questionnaire based study conducted on 100 type 2 DM patients in a tertiary teaching hospital. They were interviewed using self-designed, semi-structured questionnaire to assess adherence to medication and diet/exercise schedule. Morisky medication adherence questionnaire was used to calculate overall adherence.Results: 71%patients had some co-morbidity and were on multiple medications. Average daily modifications taken by patients was 4.1±2.23 (mean+SD). Only 47% patients were found adherent. Illiteracy (11%), Language (10%), complicated dosages (8%), adverse drug events (6%), heavy outpatient load (6%), psychological illness (6%), and financial (4%) were common reasons for non-adherence. Surprisingly, total number of medicines prescribed did not interfere with adherence.58% patients were aware of the importance of medication, diet and exercise but 42% patients were not aware of the consequences of non-adherence. 65% patients adhered to diet control and 43% patients followed exercise schedule.Conclusions: 53% of type 2 DM patients on multi-drug therapy were not adhering to prescribed medication making it a major hurdle to its management. The most important cause of non adherence were not comprehending instructions due to various reasons like illiteracy, language issues, complicated schedules and less doctor-patient interaction due to heavy OPDs. Also 42% of the patients were not aware of the consequences of non adherence to therapy, diet and exercise. Hence, a multidimensional approach with adequate medication and emphasis on adherence to prescribed medication, diet and exercise schedule requires implemented. Health professionals can play a major role in improving adherence by increasing interaction with patients.
RESUMEN
Background: Treating chronic pain has always been a great challenge for the treating physician. As the available pharmacotherapy do not always yield desired results, wider armamentarium is needed in tackling the chronic pain. Hence gabapentinoids are often considered, but it has led to widespread off label use of these groups of medications. Hence a study of consumption pattern was carried out to assess the usage of gabapentinoids.Methods: The consumption pattern of gabapentinoids (gabapentin/ pregabalin/ any combination) was recorded from the medical stores and dispensary of tertiary care teaching hospital.Results: There is an upward trend in the usage of all gabapentinoids between 2012 to 2017 and pregabalin was seen to be the commonly used gabapentinoid. In the recent years apart from individual gabapentinoids there is a trend favoring use of FDCs of gabapentinoids with nortryptyline and methylcobalamine.Conclusions: The increase in the usage pattern should alarm us to look into the off label uses of gabapentinoids. As there is a possibility of abuse and misuse of gabapentinoids clear guidelines regarding the same is the need of the hour.